Update after RE visit

jilligan14

So I've finally finished all my testing and the main problems are my PCOS and my high-ish prolactin levels.

The RE prescribed cabergoline to bring down my prolactin level. I need to take it once a week and will start tonight.

He also wants me to start letrozole next cycle (CD 3-7). He said it's up to me if I want to do the monitoring. I'm so confused because so many women on here claim that it's crucial to do ultrasound monitoring while using fertility drugs but the RE doesn't seem to think that it's necessary. Um, I'm confused....

My insurance pays for some fertility stuff but I honestly don't know what it would end up costing us to do the monitoring (I'll see if I can talk to their financial department about it). I mean, it would obviously be a LOT cheaper to NOT do the monitoring. He also said that I'd use a trigger shot with the monitoring but no shot if I decide to go with the no-monitoring route. So many options! My brain is already hurting...

Also, my 2013 results (from my first RE) show that my testing for immunity to rubella was "inconclusive." I'm pretty sure I got this immunization as a kid and don't know if it's common to need a booster as an adult? He said I could come in to retest it but if I do need it, I have to wait a month before TTC (after taking the shot). It seriously seems like one thing after another! I'm hoping that the retest will show that I don't need it!

Anyway, H and I want to try one more natural cycle (since it's too late for this cycle since I'm on CD10) and then go for the letrozole. We just don't know about doing the monitoring/trigger shot...

Any feedback, experiences, opinions, etc would be appreciated. It's really hard for me to give up on the dream of a natural conception but I'm turning another year older in November and am starting to feel the need to get really aggressive with this whole process.

Thanks for letting me vent. You guys are such a wonderful support network!

1inthehopper

That is so much information for you to comprehend, my head would be spinning too! Yay for more options though! Glad you got some answers and FX this month is your month and you won't even have to make the other choices!!

Sporty1216

That's a lot to take in and take on! I don't have any personal experience, but just wanted to say good luck sorting through things! I hope you and your DH can make a decision you both feel confident about. And, as @1inthehopper said, it would be great if this was your month as you didn't have to make any choices at all!

emsmama15

I'm keeping my fingers crossed that this is your month Jill!

happyktmom

I feel like I can help a little...
So, the letrozole/Femara has little to no chance of causing cysts, does not affect lining and has less of a chance of multiples (from my research when I took it) and therefore does not need monitoring in the way Clomid does.  That's why the RE doesn't care if it's monitored or not. 
With the rubella thing - I was not immune to Measles.  I found this out when there was a Measles outbreak and the pediatric clinic I worked for wanted to check all the staff (I'm a nurse) for immunity.  I went ahead and got a booster.  The chances of you getting exposed to Rubella are slim to none.
You don't have to give up on your dream of going natural.  Why don't you try the cabergoline and see how this cycle and next cycle go.  Maybe that will solve the problem!!
Good luck!

jilligan14

@happyktmom - thanks for sharing this! It's reassuring to hear that the Letrozole doesn't need the same monitoring as Clomid. I've just heard so many horror stories about Clomid and figured that Letrozole was similar but I guess it's not. It would definitely save me money to not do the monitoring (as well as save me all the driving time back and forth from the clinic). I feel like the Rubella thing is pretty rare but the doc had me all worried about it. I'm just confused since my results were "inconclusive" so I might just get retested and see if it comes up with a better, more clear result.

Yes, I'm trying the cabergoline this cycle and hopefully that will do the trick! I'm also keeping up with the high protein/low carb diet and drinking the nasty herbs from my acupuncturist. So hopefully my body will be in balance this cycle and everything will work out perfectly. I can only hope...

thistle8677

@jilligan14 I am glad you got some medication for the prolactin levels. I'm going tomorrow to get bloodwork for this. As you know, I can't see an RE with my current insurance, so my Obgyn has agreed to test because of my leaky nipple...(sounds like a ballad, no?!)

Thanks for the update. It really does sound like you're closer than ever to getting some things resolved and I'm wishing you all the best!!!
Please keep us posted.
Xoxo >:D<

jilligan14

@thistle8677 - I'm glad you're getting that leaky nipple checked out (and I think that would make a good band name - "The Leaky Nipples" - what do you think?!?!?!)! The high prolactin level seems like an easy issue to address and I only have to take 1/2 a pill once a week (on a side note, it cost $25 WITH insurance for just TWO pills!). I do feel like I'm finally moving forward with some concrete options but I hope that @1inthehopper, @Sporty1216, @emsmama15, and @happyktmom are right that THIS will be my cycle and that I won't even need to do the Letrozole. Please, please, please let this be true!!!  [-O<

dolphin012

@jilligan14 -- i haven't used letrozole so can't offer any advice. But did want to say i completely empathize with all the decisions that go with treatments. It can be so overwhelming. Hang in there and glad to see you got some specific feedback on the letrozole. Fingers crossed this is your cycle so it call becomes a moot point!! 

thistle8677

@jilligan14 The Leaky Nipples with their hit song "Cosmic Conundrum #cc"
\m/

jilligan14

@thistle8677 YESSSS!!! Hahahaha!!!

Infantino22

Just reading it makes my brain hurt -- FX for a plan that helps!

KLake42

I believe that letrozole alone tends to give me 1-2 follicles, instead of the 0-1 that I get on my own.  So it wouldn't likely cause multiples for me.  But I have seen on these boards a person who popped out enough follicles on letrozole that they had to cancel the IUI, so it's possible.

Maybe monitor once, and if your ovaries aren't going crazy, then try a couple non-monitored cycles?

I do think it's helpful to have the trigger.  Timing is EVERYTHING with an IUI, and it takes a lot of guess work out of it.

That said, I know how to have an IUI by this point.  Jury is out on whether I know how to get pregnant with one.

jilligan14

@klake42 I'm not actually doing IUI yet, just trying the drugs and TI first. But it does sound like the trigger shot helps things so I may go that route. I really have no idea how my body will respond to it but I do like the idea of monitoring the first one just to get an idea of how things are going.